How digital drug users could help to halt the US opioid epidemic

With the tip of her syringe, Brandi pokes at a grey lump of heroin in a spoon. It’s a new variety of the drug that has shown up on the market in the past few days, and Brandi likes it. “I feel this more, I feel more of the pain resistance,” she says.

Once it has dissolved into a liquid, she injects it into her arm, then uses a fresh needle to inject the skinny arm of another woman. “She does it better than the hospital,” the woman comments.

“I’ll help anybody who needs it,” Brandi explains to public-health researcher Daniel Ciccarone of the University of California, San Francisco, who has been filming the entire process.

Ciccarone’s team has embedded with Brandi — whose name has been changed for this story — in Charleston, West Virginia, documenting her interactions without judgement or interference. Later, the group will analyse this video, in addition to half a dozen other videos of drug users from across the city, logging details big and small. Brandi does not heat the solution on the spoon, for instance, and that may increase the likelihood of spreading viruses such as HIV. And tests reveal that what she’s taking has been laced with fentanyl, a synthetic drug up to 50 times more powerful than heroin.